BMJ, doi: 10.1136/bmj.38302.504063.8F, (Published 13 December 2004)

PAPERS

Risk of ischaemic stroke in people with migraine: systematic review and meta-analysis of observational studies

Mahyar Etminan ¹, Bahi Takkouche ², Francisco Caamaño Isorna ², Ali Samii ³

¹ Divisions of Epidemiology, Royal Victoria and Vancouver Hospitals, Canada
² Department of Preventive Medicine, University of Santiago de Compostela, Spain
³ Department of Neurology, University of Washington, Seattle, WA 98195, USA

Objective To explore the association between migraine and risk of ischaemic stroke.

Design Systematic review and meta-analysis.

Data sources Observational studies published between 1966 and June 2004 (identified through Medline and Embase) that examined the association between migraine and risk of ischaemic stroke.

Results 14 studies (11 case-control studies and 3 cohort studies) were identified. These studies suggest that the risk of stroke is increased in people with migraine (relative risk 2.16, 95% confidence interval 1.89 to 2.48). This increase in risk was consistent in people who had migraine with aura (relative risk 2.27, 1.61 to 3.19) and migraine without aura (relative risk 1.83, 1.06 to 3.15), as well as in those taking oral contraceptives (relative risk 8.72, 5.05 to 15.05).

Conclusions Data from observational studies suggest that migraine may be a risk factor in developing stroke. More studies are needed to explore the mechanism of this potential association. In addition, the risk of migraine among users of oral contraceptives must be further investigated.

---

(Accepted 9 November 2004)
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Related Articles

Migraine may be a risk factor for stroke
BMJ 2005 330: 0. [Full Text]

Migraine and ischaemic stroke

D J Thomas
BMJ 2005 330: 54-55. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

• Adami, A., Rossato, G., Cerini, R., Thijs, V. N., Pozzi-Mucelli, R., Anzola, G. P., Sette, M. D., Finocchi, C., Meneghetti, G., Zanferrari, C., On behalf of the SAM Study Group, (2008). Right-to-left shunt does not increase white matter lesion load in migraine with aura patients. Neurology 71: 101-107 [Abstract] [Full text]  
• Lee, S. -T., Chu, K., Jung, K. -H., Kim, D. -H., Kim, E. -H., Choe, V. N., Kim, J. -H., Im, W. -S., Kang, L., Park, J. -E., Park, H. -J., Park, H. -K., Song, E. -C., Lee, S. K., Kim, M., Roh, J. -K. (2008). Decreased number and function of endothelial progenitor cells in patients with migraine. Neurology 70: 1510-1517 [Abstract] [Full text]  
• (2008). Contraception in Women with Medical Problems. JWatch Women's Health 2008: 2-2 [Full text]  
• Pezzini, A., Grassi, M., Del Zotto, E., Giossi, A., Monastero, R., Dalla Volta, G., Archetti, S., Zavarise, P., Camarda, C., Gasparotti, R., Magoni, M., Camarda, R., Padovani, A. (2007). Migraine Mediates the Influence of C677T MTHFR Genotypes on Ischemic Stroke Risk With a Stroke-Subtype Effect. Stroke 38: 3145-3151 [Abstract] [Full text]  
• Moskowitz, M. A., Kurth, T. (2007). Blood Vessels, Migraine, and Stroke. Stroke 38: 3117-3118 [Full text]  
• MacClellan, L. R., Giles, W., Cole, J., Wozniak, M., Stern, B., Mitchell, B. D., Kittner, S. J. (2007). Probable Migraine With Visual Aura and Risk of Ischemic Stroke: The Stroke Prevention in Young Women Study. Stroke 38: 2438-2445 [Abstract] [Full text]  
• Kurth, T. (2007). Migraine With Aura and Ischemic Stroke: Which Additional Factors Matter?. Stroke 38: 2407-2408 [Full text]  
• Kurth, T., Gaziano, J. M., Cook, N. R., Bubes, V., Logroscino, G., Diener, H.-C., Buring, J. E. (2007). Migraine and Risk of Cardiovascular Disease in Men. Arch Intern Med 167: 795-801 [Abstract] [Full text]  
• Wammes-van der Heijden, E. A., Rahimtoola, H., Leufkens, H.G.M., Tijssen, C. C., Egberts, A. C.G. (2006). Risk of ischemic complications related to the intensity of triptan and ergotamine use.. Neurology 67: 1128-1134 [Abstract] [Full text]  
• Post, M. C., Budts, W. (2006). The Relationship Between Migraine and Right-to-Left Shunt: Fact or Fiction?. Chest 130: 896-901 [Abstract] [Full text]  
• The ESHRE Capri Workshop Group, (2006). Hormones and cardiovascular health in women. Hum Reprod Update 12: 483-497 [Abstract] [Full text]  
• Kurth, T., Gaziano, J. M., Cook, N. R., Logroscino, G., Diener, H.-C., Buring, J. E. (2006). Migraine and risk of cardiovascular disease in women.. JAMA 296: 283-291 [Abstract] [Full text]  
• Hayden, J. A., Cote, P., Bombardier, C. (2006). Evaluation of the quality of prognosis studies in systematic reviews.. ANN INTERN MED 144: 427-437 [Abstract] [Full text]  
• Anzola, G. P., Morandi, E., Casilli, F., Onorato, E. (2006). Different degrees of right-to-left shunting predict migraine and stroke: Data from 420 patients. Neurology 66: 765-767 [Abstract] [Full text]  
• (2005). Other articles noted. Evid. Based Med. 10: 127-128 [Full text]  
• Diener, H. C., Kurth, T. (2005). Is migraine a risk factor for stroke?. Neurology 64: 1496-1497 [Full text]  
• (2005). Migraine as Stroke Risk Factor: A Meta-Analysis. JWatch Neurology 2005: 3-3 [Full text]  
• (2005). Migraine Headache: A Risk Factor for Ischemic Stroke?. JWatch Emergency Med. 2005: 6-6 [Full text]  
• Thomas, D J (2005). Migraine and ischaemic stroke. BMJ 330: 54-55 [Full text]  

Rapid Responses:

Read all Rapid Responses

Oral contraceptive drug type/ dose response data

sarah j mee
bmj.com, 15 Dec 2004 [Full text]

Hormonal contraceptives cause migraine and ischaemic strokes.

Ellen C G Grant
bmj.com, 16 Dec 2004 [Full text]

Pooled risk of ischaemic stroke is misleading

E Anne MacGregor
bmj.com, 20 Dec 2004 [Full text]

Several inconsistencies and errors in the study on migraine and risk of ischemic stroke

Tobias Kurth, et al.
bmj.com, 22 Dec 2004 [Full text]

Re: Several inconsistencies and errors in the study on migraine and risk of ischemic stroke

Tobias Kurth, et al.
bmj.com, 25 Dec 2004 [Full text]

Stroke and migraine: meta-analysis versus basic sciences?

Vinod K Gupta
bmj.com, 29 Dec 2004 [Full text]

Is it migraine or stroke or both?

Dirk Ulbricht
bmj.com, 31 Dec 2004 [Full text]

Risk of ischaemic stroke in people with migraine: Authors' response

Mahyar Etminan
bmj.com, 4 Jan 2005 [Full text]

Most Common Headache?

James Hickman
bmj.com, 12 Jan 2005 [Full text]

Hormonal contraceptives cause migraine, ischaemic and haemorrhagic strokes.

Ellen C G Grant
bmj.com, 13 Jan 2005 [Full text]

Migraine; a contraindication to combined oral contraception

Helen K Crispin
bmj.com, 4 Feb 2005 [Full text]